Clarence is a 74-year-old white man hospitalized for evaluation of dementia progression and recent hearing difficulty. He was diagnosed with Parkinson’s disease 5 years ago. He has been taking L-dopa...

Clarence is a 74-year-old white man hospitalized for evaluation of dementia progression and recent hearing difficulty. He was diagnosed with Parkinson’s disease 5 years ago. He has been taking L-dopa and furosemide (Lasix). He lives wife, who is his primary caregiver. Clarence is 5’10” and currently weighs 155 lb. His medical chart indicates that his weight was 170 lb at his last hospital visit 6 months ago, after a fall. Clarence’s wife notes that his appetite and hearing seem to have changed and he shows little interest in food at meal times. They don’t talk much during meals and staff have observed his wife helping him eat and suspect some problems with nutrition. His wife describes his eating is very slow, sometimes taking 2 hours for a meal. He coughs a lot after he eats. When asked about whether Clarence is losing weight his wife wasn’t sure, but said his pants do seem to be getting looser. Inadequate energy intake r/t decreased food intake as evidenced by weight loss and clothes getting looser. Difficulty swallowing related to PD as evidenced by slow eating pace and coughing during meals.

 Nutrition Care Questions

1. What dietary advice do you have for Clarence and his caregiver?

2. What changes in Clarence’s diet would you recommend?

3. What other evaluations does Clarence need?

4. What possible food-drug interaction could be occurring?